It seems like a simple question: Is it ethical to subject a patient to substandard medical care when there is better care available? Instinctively, most people would answer that it is not. This makes the practice of having patients treated by inexperienced residents rather than seasoned doctors a worrisome one. Is it really ethical to sacrifice patients' health in order to train doctors? It is a difficult question, and doctors legitimately worry about patients who might be harmed in the process of training doctors.
The worry over this ethical issue, however, creates an entirely new ethical issue. Because many doctors do not want to risk too much while training residents, they give residents too little authority and as a result too little confidence. Young doctors who are not permitted to stand on their own fail to develop the confidence and real experience necessary to become good doctors. Their future patients are then exposed to the consequences of this cautious, flawed training.
Is this ethical? Should future patients be sacrificed in order to guarantee the best possible treatment for current patients, or should it be the other way around? Nobody wants to be part of a medical trial run, with his life on the line; yet nobody wants to be the recipient of treatment from a doctor who does not display the proper level of confidence or good training, either. Both groups of patients seem to have the right to the best possible treatment, but their interests in this case conflict significantly.
http://www.nytimes.com/2009/03/17/health/17mind.html?ref=health
2 comments:
You’re right in that “Is it ethical to subject a patient to substandard medical care when there is better care available?” is an ethical rubik’s cube that’s certainly worth grappling and twist with.
When I am faced with these issues that present themselves as complicated, multifaceted, and multi-shaded puzzles, and I’m stuck on how to proceed, I defer to my default. This is of course to address the ethical enigma from a practical perspective. We can only do what we can, so when we consider answers to ethical problems we should consider only the solutions that we are capable of bringing about (until our capabilities change that is). Looking at things in a practical way is, in and of itself, practical.
Even though personally I would hate getting treated by a resident instead of a veteran doctor, since I have no better way to answer the question posed in this blog, I have to agree with the answer that a realistic line of thinking gives us. Granted what this blog says to be true, in that “Young doctors who are not permitted to stand on their own fail to develop the confidence and real experience necessary to become good doctors,” then residents have to be given adequate responsibility. If no resident were, then we wouldn’t have a single good doctor, which simply isn’t acceptable. I suppose that we have to trust that the system will be able to establish a rough point at which residents are given just enough challenge in order to become a future confident doctor, while at the same time they aren’t being given any additional responsibility past that point, so that no patients are exposed to any unnecessary risk.
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